CHILDHOOD OBESITY TRAILBLAZER PROGRAMME

PROSPECTUS Foreword

Undoubtedly, childhood obesity is one of the biggest public health challenges we face as a country. It is a problem which unjustly affects children in the more deprived areas, who are more than twice as likely to be obese. That is why, in the second chapter of government’s childhood obesity plan, we set the ambition to halve childhood obesity and significantly reduce the gap in obesity between children in the most and least deprived areas by 2030.

We need you alongside us. Where we live plays a huge role in our health and when it comes to improving the health of local communities, local leaders are the real experts. I know you are committed to this issue, which is why I am excited for the opportunities this programme brings.

This trailblazer programme is about supporting innovation, harnessing the full potential of local levers and sharing learning. It is about tackling obstacles head on and finding solutions together, including actions government can take to enable ambitious local action.

This is your opportunity to not only improve the health of children and families in your community, but across England.

Steve Brine MP Parliamentary Under Secretary of State for Public Health and Primary Care

The transfer of responsibility for public health in 2013 to councils has sparked a surge in innovative programmes. Examples include working with schools and early years settings, supporting families and their children who are living with obesity and funding specialised weight management programmes.

We must now build on this to make sure the health and wellbeing of children is protected. We look forward to seeing many more examples of local energy and innovation in the months and years to come, and to seeing the measurable impact it will have.

This trailblazer programme is a great opportunity for councils to work with local partners to develop innovative projects to tackle obesity, particularly amongst those groups most vulnerable to it and health inequalities. We encourage councils to submit an expression of interest for a funded discovery phase to scope out these new ideas.

Councillor Ian Hudspeth Chair of LGA Community Wellbeing Board Context

Childhood obesity is one of the biggest health problems this country faces. Around a fifth of children in England are overweight or obese by the time they start primary school aged five, and this rises to one third by the time they leave aged 11.

The burden of childhood obesity is being felt the hardest in more deprived areas - low income households are more than twice as likely to be obese than those in higher income households and this inequality gap is increasing. Children from black and minority ethnic families are also more likely than children from white families to be overweight or obese. We must address these disparities to ensure that all children, regardless of background, have the best start in life.

Being overweight seriously affects quality of life and health. It increases the risk of heart disease, stroke, type 2 diabetes, non-alcoholic fatty liver disease and some cancers in adults. It is also associated with bullying in children and stigma in both adults and children and is associated with common mental health disorders. Children who live at home with at least one parent or carer who is obese are more at risk of becoming obese themselves.

Obesity is a complex problem with different but often interlinked causes. No single measure is likely to be effective on its own in tackling obesity.

In June 2018, government published the second chapter of the Childhood Obesity: Plan for action. The plan includes promotion of an active mile initiative in primary schools and consultations on a range of measures including restricting promotion and advertising of food and drink products high in fat, salt and sugar; introduction of mandatory calorie labelling food served outside the home; banning the sale of energy drinks to children and strengthening of nutrition standards in the Government Buying Standards for Food and Catering Services.

The plan sets the bold ambition to halve childhood obesity by 2030 and significantly reduce the gap in obesity between children from the most and least deprived areas.

This ambition requires a concerted effort and a united approach across councils, businesses, schools, health professionals and families up and down the country.

There is real determination among councils to tackle childhood obesity but there are very real obstacles. To address this, government committed to a three year trailblazer programme to work with council-led projects in England to tackle childhood obesity at a local level, with a particular focus on inequalities. We are looking for councils to take bold action, harnessing existing powers and overcoming barriers to address this significant challenge. The Programme

Aims

The trailblazer programme aims to:

• test the limits of existing powers through innovative and determined action to tackle childhood obesity • share learning and best practice to encourage wider local action and • develop solutions to local obstacles and consider further actions government can take to enable ambitious local action and achieve changes at scale.

The programme model

The programme encourages a service design approach to be used by councils. This will start with a discovery phase with up to 12 councils and be followed by up to five trailblazer councils selected to tackle childhood obesity over a three year period. There will be £100,000 worth of funding and project support available to each trailblazer per year. Councils will be asked to budget for £75,000 of expenditure each year with £25,000 allocated for delivery support and subject matter expertise arranged in collaboration with the Local Government Association (LGA).

This funding is to support trailblazer councils to participate in the programme without disrupting usual service delivery and it is not intended to cover core service delivery.

The programme will be managed by the LGA commissioned by the Department of Health and Social Care (DHSC). The DHSC, Public Health England (PHE) and the Association of the Directors of Public Health (ADPH) will help steer the programme.

Call for action

Councils are invited to submit an expression of interest to carry out a discovery phase. Within the expression of interest the lead council will be expected to describe the drivers and aspects of childhood obesity to explore, the evidence of local need and inequalities and the approach for the discovery phase including community partner involvement.

Who can apply

The programme is open to all English councils, either individually or as a partnership. If you are forming a partnership of councils (and other organisations), a single council must lead the project. District councils are encouraged to participate and should work in partnership with their county council who will lead the bid.

Expressions of interest will need to be signed by the principal council’s lead member for public health, chief executive and director of public health using the form provided. You are also encouraged to include the signature of leaders from partners relevant to the area you are looking to address.

Councils that are in receipt of government funding for initiatives that are related to childhood obesity, eg increasing physical activity rates, will be required to state this in their applications. This will not automatically exclude councils from selection, but the impact of other initiatives and funding will be considered where there is overlap in the local project aims. Further information from councils may be requested in such cases. Discovery phase

The first stage of the programme is a 12 week discovery phase which will support councils to research and understand the needs, behaviours and experiences of users (such as families, parents, professionals and businesses).

Up to 12 councils will receive funding of £10,000 to bring local partners through the whole systems approach, undertake discovery and develop a detailed proposal for the three year programme.

Councils will be supported to apply learning from existing programmes and approaches, such as the Whole Systems Approach and behavioural insights techniques to refine and tailor local plans. Projects will also be supported to develop their discovery approach by a delivery support partner.

The discovery phase will conclude with the submission of an application for three year funding by Friday 5 April.

Final applications will include an implementation plan for the three year programme and will be expected to demonstrate innovation, how your community is at the centre of the approach, scalability, sustainability and methods of measuring success. We then intend to visit your site to learn more about your proposal before selecting the five councils to move forward to implementation. Trailblazer three year programme

In early May 2019, up to five councils will be selected to lead projects to implement their plans. At the end of the discovery phase milestones will be agreed for the three year programme which will include triggers to release funding. The programme will feature three phases, though they will be flexible according to each of the trailblazer project plans. It is expected that there will be a delivery that can be evaluated in the first year of the programme.

Programme timeline

| Phase | When | |--------------------------------------------|---------------------------| | Discovery phase kick-off event | January 2019 | | 1 - Discovery | Undertaking user research and planning | January-April 2019 | | Review applications for three year funding and on-site visits | April 2019 | | 2 - Develop and deliver | Project set-up, design, making and testing solutions | 2019-20 | | 3 - Delivery | Iterating and strengthening a solution | 2020-21 | | 4 - Deliver, review and expand | Embedding and reviewing solutions, share knowledge and improve | 2021-22 |

Project support resources

**Government expert support** – A group of experts across government is committed to support the trailblazer programme. They will meet regularly to help find solutions to local challenges and consider the implications for future policy.

**Delivery support partner** – To provide support and coaching from the discovery phase onwards. The support partner will advise on user engagement and use service design principles to assist the development of your project. This partner will be commissioned by the LGA.

**Subject matter expert** – Expert individual or consultancy support will have technical/commercial expertise in your area and provide constructive challenge. The LGA will work with the council to find the right expertise for the particular project. Shared Commitments

The LGA, DHSC, PHE and the delivery support partner are keen to support the trailblazer projects develop ground-breaking and innovative initiatives.

Our commitment to you:

• we will support and assist you to creatively address the issues you are exploring • we will encourage you to consistently focus on the beneficiaries of your work • we will provide on-site support, practical workshops, subject matter experts, service design and evaluation support • we will facilitate opportunities to engage with the other local areas • we will help you consider and develop solutions to local obstacles and consider further actions government can take to enable ambitious local action • we will promote the outcomes and learning from your work with the rest of the sector.

In return we are asking for commitment from funded councils.

Your commitment to us:

• you will work as a multi-disciplinary team in addressing the issues you are exploring • you will commit to putting the needs of beneficiaries and communities at the heart of your work, with a focus on local inequalities (ie disparities across ethnic groups and areas of deprivation) • you will evaluate your project(s) and engage with the overall programme evaluation • you will ensure that senior leadership is engaged in the programme • you will work openly with other trailblazers • you will commit to sharing the learning with the rest of the sector via events, workshops, webinars, blogs and other methods. Areas to explore

The drivers of childhood obesity are varied, including social, environmental, individual, physiological and structural components. It is acknowledged that systemic change is required, especially to support families in the most deprived areas who are faced with a disproportionate impact of these drivers.

While councils do not have full control of these drivers, they have a range of levers and opportunities to influence them, including through local policies, partnerships, shaping the local environment and service delivery. We want to test the boundaries of local action, understand how levers can be used together to best effect and importantly, how they can be improved.

Below, we set out examples for some of the key drivers and a vision for improvement. They are broad and could encompass a variety of levers and approaches to achieve them. While we will be looking for the overall trailblazer programme to capture activity across a range of areas, this is not exhaustive, nor is it intended to limit your ambitions.

- Children’s exposure to food advertising can have immediate and long-term impact on their health by encouraging greater consumption after seeing adverts and altering their food preferences. With marketing for food and drink high in fat, salt and sugar dominating many public spaces, children’s exposure is high. We want to see a reduction in children’s exposure to advertising of products high in salt, sugar and fat across the local area including high streets, street furniture, transport systems and local events, particularly in areas of high child footfall.

- Many high streets are densely populated with fast food outlets, cafés and restaurants that offer food and drink that can be high in salt, sugar and fat and have limited healthier options. The accessibility and convenience of such foods, which are inexpensive and quick to prepare, can be enticing for families. We want to see the local food and drink offer redressed, with diversity across high streets, town centres and shop parades so that healthier food and drink is accessible for the whole community and can become the default option.

- Only one in five children meet the chief medical officer’s recommendation of 60 minutes of physical activity a day. With reservations around active travel due to accessibility and safety concerns, limited access to green space and cost barriers to leisure facilities in some areas, opportunities for physical activity can be limited. We want to see increased opportunities for physical activity locally that are accessible and safe for families and young people to become more active.

- Key public health, health and children’s services can be disjointed and opportunities for prevention and intervention may not be fully utilised. With disparities in the provision of weight management services across England, many children living with obesity do not have access to appropriate services. We want to see existing services linked effectively and opportunities to provide both prevention and intervention support maximised, with accessible and effective care that meets the needs of each high-risk child.

We encourage councils to look across their local system, consider the levers, and how they can be galvanised to deliver their vision of a healthier generation of children in your community.

With families in more deprived areas and certain ethnic groups disproportionately carrying the burden of childhood obesity and the inequalities gap widening, it is paramount that councils carefully consider the local demographic and specifically tackle these inequalities through their chosen approach. How to apply?

The Childhood Obesity Trailblazer Programme is now open for expressions of interest. Please email cotp@local.gov.uk to request a form. The deadline for submission of your expression of interest is Friday 30 November 2018.

Each expression of interest must address each question directly, not exceeding the stated maximum word length of 500 words for the assessed questions.

Expression of interest questions

Project title

1. Which driver(s) do you plan to address and how would this positively impact the local inequalities profile (ie disparities across ethnic groups and areas of deprivation)?
2. What is the vision for your local area in tackling this issue and why is this important for your area?
3. During the discovery phase, what are the levers you would like to explore and how will you involve key stakeholders and target groups?
4. What are the key outputs, milestones and measures of success for the discovery phase?
5. Who are the key members of your project team for the discovery phase including name, position, organisation, role in this phase?

Expressions of Interests will be evaluated by representatives from the DHSC, PHE, ADPH and LGA. Up to 12 discovery phase councils will be announced by early January 2019.

If successful, lead councils are expected to agree and sign the funding agreement by 9 January 2019.

What we are looking for

You are the experts for your local area. We are looking to you to identify the actions during the discovery phase that will have the greatest impact on childhood obesity. While there is no single solution to the issue of childhood obesity, we will consider applications that focus on addressing a specific driver of childhood obesity, as well as those that aim to address multiple drivers. For the trailblazer programme to explore a cross-section of drivers and test a variety of levers, we will aim to select a group of councils who, as a collective, represent a range of activity.

Discovery phase Expression of Interest

| What we are looking for? | What we are not looking for? | |--------------------------------------------------------------|------------------------------------------------------------------| | Clear description of ‘problem’ to tackle with careful consideration of local needs and inequalities. | An overview of the national issue | | An outline of the levers you think would help achieve your local vision and openness to refining these through the discovery phase | Pre-defined set of limited actions and levers to deliver the project | | Outputs from the discovery phase | Pre-defined outcomes for the whole project | | Methods of user engagement described with external support if required | Unclear user engagement methodology | | Partnership and community participation arrangements | Councils working in silo without forming partnerships and engaging the community | | Multi-disciplinary teams | Council dominated teams |

If you have any questions about the programme or expression of interest process, please visit www.local.gov.uk/cotp or contact: cotp@local.gov.uk. Regularly updated Frequently Asked Questions are also available on our webpage.